Strategies to improve treatment outcome in gastric cancer: A retrospective analysis of patients from two high-volume hospitals in Korea and China

Kun Yang, Yoon Young Choi, Wei Han Zhang, Xin Zu Chen, Mi Kyung Song, Jinae Lee, Bo Zhang, Zhi Xin Chen, Hyoung Il Kim, Jia Ping Chen, Jae Ho Cheong, Zong Guang Zhou, Woo Jin Hyung, Jian Kun Hu, Sung Hoon Noh

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Abstract

China has high incidence of gastric cancer (GC). However, the treatment outcomes of China were unsatisfactory compared to those of Korea. We performed this study to compare tumour characteristics, treatment parameters, and survival outcomes of GC patients between Korea and China based on the databases of two high-volume hospitals, with the aim of identifying indicators of GC prognosis. Data of patients undergoing gastrectomy for GC from 2006 to 2010 were analysed retrospectively. Subgroup survival analyses, stratified by clinicopathologic factors and multivariable analyses, were performed. The interactive roles of chemotherapy and D2 lymphadenectomy for overall survival were also investigated. Among 1365 Chinese and 4981 Korean patients, the proportion of early cancer detection in Chinese patients was much lower relative to that of Korean patients. There were no significant differences between countries in terms of surgical morbidity and mortality. The overall 5-year survival rates were 54.3% and 81.4%; when stratified by clinicopathologic factors, the survival were generally statistically higher in Korean patients. Gender, age, T stage, N stage, extent of lymphadenectomy, radicality of surgery, resection type, and chemotherapy were independently associated with survival in patients without metastasis. Survival rates for stage II and III GC differed significantly between the two countries, but this difference was eliminated among patients who underwent D2 lymphadenectomy or received chemotherapy. These treatments were given to patients with advancedstage diagnoses (approximately 20% and 80% of patients, respectively). Treatment type was selected as independent prognostic factors in stage I-III and D2/D2+, with chemotherapy resulting in the best prognosis. Many differences in GC tumour characteristics exist between two countries. Early cancer detection and standardized treatment in Korea contribute to superior survival rates. Promotion of an early screening program, training and dissemination of standard D2 lymphadenectomy, and appropriate applications of chemotherapy would improve survival outcomes.

Original languageEnglish
Pages (from-to)44660-44675
Number of pages16
JournalOncotarget
Volume7
Issue number28
DOIs
Publication statusPublished - 2016 Jan 1

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High-Volume Hospitals
Korea
Stomach Neoplasms
China
Lymph Node Excision
Drug Therapy
Survival
Survival Rate
Early Detection of Cancer
Therapeutics
Gastrectomy
Survival Analysis
Statistical Factor Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Yang, Kun ; Choi, Yoon Young ; Zhang, Wei Han ; Chen, Xin Zu ; Song, Mi Kyung ; Lee, Jinae ; Zhang, Bo ; Chen, Zhi Xin ; Kim, Hyoung Il ; Chen, Jia Ping ; Cheong, Jae Ho ; Zhou, Zong Guang ; Hyung, Woo Jin ; Hu, Jian Kun ; Noh, Sung Hoon. / Strategies to improve treatment outcome in gastric cancer : A retrospective analysis of patients from two high-volume hospitals in Korea and China. In: Oncotarget. 2016 ; Vol. 7, No. 28. pp. 44660-44675.
@article{b09a6041ffb9456383d16ef78c61183b,
title = "Strategies to improve treatment outcome in gastric cancer: A retrospective analysis of patients from two high-volume hospitals in Korea and China",
abstract = "China has high incidence of gastric cancer (GC). However, the treatment outcomes of China were unsatisfactory compared to those of Korea. We performed this study to compare tumour characteristics, treatment parameters, and survival outcomes of GC patients between Korea and China based on the databases of two high-volume hospitals, with the aim of identifying indicators of GC prognosis. Data of patients undergoing gastrectomy for GC from 2006 to 2010 were analysed retrospectively. Subgroup survival analyses, stratified by clinicopathologic factors and multivariable analyses, were performed. The interactive roles of chemotherapy and D2 lymphadenectomy for overall survival were also investigated. Among 1365 Chinese and 4981 Korean patients, the proportion of early cancer detection in Chinese patients was much lower relative to that of Korean patients. There were no significant differences between countries in terms of surgical morbidity and mortality. The overall 5-year survival rates were 54.3{\%} and 81.4{\%}; when stratified by clinicopathologic factors, the survival were generally statistically higher in Korean patients. Gender, age, T stage, N stage, extent of lymphadenectomy, radicality of surgery, resection type, and chemotherapy were independently associated with survival in patients without metastasis. Survival rates for stage II and III GC differed significantly between the two countries, but this difference was eliminated among patients who underwent D2 lymphadenectomy or received chemotherapy. These treatments were given to patients with advancedstage diagnoses (approximately 20{\%} and 80{\%} of patients, respectively). Treatment type was selected as independent prognostic factors in stage I-III and D2/D2+, with chemotherapy resulting in the best prognosis. Many differences in GC tumour characteristics exist between two countries. Early cancer detection and standardized treatment in Korea contribute to superior survival rates. Promotion of an early screening program, training and dissemination of standard D2 lymphadenectomy, and appropriate applications of chemotherapy would improve survival outcomes.",
author = "Kun Yang and Choi, {Yoon Young} and Zhang, {Wei Han} and Chen, {Xin Zu} and Song, {Mi Kyung} and Jinae Lee and Bo Zhang and Chen, {Zhi Xin} and Kim, {Hyoung Il} and Chen, {Jia Ping} and Cheong, {Jae Ho} and Zhou, {Zong Guang} and Hyung, {Woo Jin} and Hu, {Jian Kun} and Noh, {Sung Hoon}",
year = "2016",
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Yang, K, Choi, YY, Zhang, WH, Chen, XZ, Song, MK, Lee, J, Zhang, B, Chen, ZX, Kim, HI, Chen, JP, Cheong, JH, Zhou, ZG, Hyung, WJ, Hu, JK & Noh, SH 2016, 'Strategies to improve treatment outcome in gastric cancer: A retrospective analysis of patients from two high-volume hospitals in Korea and China', Oncotarget, vol. 7, no. 28, pp. 44660-44675. https://doi.org/10.18632/oncotarget.9378

Strategies to improve treatment outcome in gastric cancer : A retrospective analysis of patients from two high-volume hospitals in Korea and China. / Yang, Kun; Choi, Yoon Young; Zhang, Wei Han; Chen, Xin Zu; Song, Mi Kyung; Lee, Jinae; Zhang, Bo; Chen, Zhi Xin; Kim, Hyoung Il; Chen, Jia Ping; Cheong, Jae Ho; Zhou, Zong Guang; Hyung, Woo Jin; Hu, Jian Kun; Noh, Sung Hoon.

In: Oncotarget, Vol. 7, No. 28, 01.01.2016, p. 44660-44675.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Strategies to improve treatment outcome in gastric cancer

T2 - A retrospective analysis of patients from two high-volume hospitals in Korea and China

AU - Yang, Kun

AU - Choi, Yoon Young

AU - Zhang, Wei Han

AU - Chen, Xin Zu

AU - Song, Mi Kyung

AU - Lee, Jinae

AU - Zhang, Bo

AU - Chen, Zhi Xin

AU - Kim, Hyoung Il

AU - Chen, Jia Ping

AU - Cheong, Jae Ho

AU - Zhou, Zong Guang

AU - Hyung, Woo Jin

AU - Hu, Jian Kun

AU - Noh, Sung Hoon

PY - 2016/1/1

Y1 - 2016/1/1

N2 - China has high incidence of gastric cancer (GC). However, the treatment outcomes of China were unsatisfactory compared to those of Korea. We performed this study to compare tumour characteristics, treatment parameters, and survival outcomes of GC patients between Korea and China based on the databases of two high-volume hospitals, with the aim of identifying indicators of GC prognosis. Data of patients undergoing gastrectomy for GC from 2006 to 2010 were analysed retrospectively. Subgroup survival analyses, stratified by clinicopathologic factors and multivariable analyses, were performed. The interactive roles of chemotherapy and D2 lymphadenectomy for overall survival were also investigated. Among 1365 Chinese and 4981 Korean patients, the proportion of early cancer detection in Chinese patients was much lower relative to that of Korean patients. There were no significant differences between countries in terms of surgical morbidity and mortality. The overall 5-year survival rates were 54.3% and 81.4%; when stratified by clinicopathologic factors, the survival were generally statistically higher in Korean patients. Gender, age, T stage, N stage, extent of lymphadenectomy, radicality of surgery, resection type, and chemotherapy were independently associated with survival in patients without metastasis. Survival rates for stage II and III GC differed significantly between the two countries, but this difference was eliminated among patients who underwent D2 lymphadenectomy or received chemotherapy. These treatments were given to patients with advancedstage diagnoses (approximately 20% and 80% of patients, respectively). Treatment type was selected as independent prognostic factors in stage I-III and D2/D2+, with chemotherapy resulting in the best prognosis. Many differences in GC tumour characteristics exist between two countries. Early cancer detection and standardized treatment in Korea contribute to superior survival rates. Promotion of an early screening program, training and dissemination of standard D2 lymphadenectomy, and appropriate applications of chemotherapy would improve survival outcomes.

AB - China has high incidence of gastric cancer (GC). However, the treatment outcomes of China were unsatisfactory compared to those of Korea. We performed this study to compare tumour characteristics, treatment parameters, and survival outcomes of GC patients between Korea and China based on the databases of two high-volume hospitals, with the aim of identifying indicators of GC prognosis. Data of patients undergoing gastrectomy for GC from 2006 to 2010 were analysed retrospectively. Subgroup survival analyses, stratified by clinicopathologic factors and multivariable analyses, were performed. The interactive roles of chemotherapy and D2 lymphadenectomy for overall survival were also investigated. Among 1365 Chinese and 4981 Korean patients, the proportion of early cancer detection in Chinese patients was much lower relative to that of Korean patients. There were no significant differences between countries in terms of surgical morbidity and mortality. The overall 5-year survival rates were 54.3% and 81.4%; when stratified by clinicopathologic factors, the survival were generally statistically higher in Korean patients. Gender, age, T stage, N stage, extent of lymphadenectomy, radicality of surgery, resection type, and chemotherapy were independently associated with survival in patients without metastasis. Survival rates for stage II and III GC differed significantly between the two countries, but this difference was eliminated among patients who underwent D2 lymphadenectomy or received chemotherapy. These treatments were given to patients with advancedstage diagnoses (approximately 20% and 80% of patients, respectively). Treatment type was selected as independent prognostic factors in stage I-III and D2/D2+, with chemotherapy resulting in the best prognosis. Many differences in GC tumour characteristics exist between two countries. Early cancer detection and standardized treatment in Korea contribute to superior survival rates. Promotion of an early screening program, training and dissemination of standard D2 lymphadenectomy, and appropriate applications of chemotherapy would improve survival outcomes.

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DO - 10.18632/oncotarget.9378

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